Not sure of your ES symptoms, so my case may be different. But I can share what's happened to me over the past few weeks in the hope that it could be helpful.
As a reminder, I started all of this being diagnosed with bilateral carotid artery dissections in May of 2014. After 3 months on blood thinners, I was pronounced "healed". A year later my dentist commented on my extended styloid processes and that started this journey - I'm so glad he did!!!
Dr. Bojrab was great -- impressed with his style, credentials, and approach. He consulted a multi-discipline team to decide the best treatment plan. The first step was a consult with an endovascular neurosurgeon, Dr. Richard Fessler of Michigan Head & Spine. I can't say enough positive things about Dr. Fessler; exceptional skills, great bedside manner, and very pragmatic. He felt strongly that what I needed was a carotid angiogram with the possible placement of stents in my carotid arteries. He noted psuedoaneurysms in both carotid arteries. The stents would allow them to heal, as well as protecting from future injury.
I had this procedure done on 15 December, with stents placed on both sides. All went very well. He described by styloid processes as "tusks", so apparently they're pretty large. What's interesting is he has strongly advised me against any sort of ES surgery. He told me at my follow-up appointment today that the surgery is VERY risky and that the potential complications aren't worth the potential benefit.
For now, I'm healing pretty well. We have a follow-up plan, and I feel very positive. Perhaps a consult with Dr. Fessler might be beneficial.
Best of luck!